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<br /> � . .. � PC Exhibit A
<br /> , � ,� , ,City of +O�ro:no- : _--..- _-__--_-_
<br /> . . :�arian.ce .Applicati,on =� ,. =.� :
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<br /> , � StreetAtldress. .: ApPlicatio`n# ` :/4°�`-.� C��-S
<br /> � 2750 Kelley ParkwaY � Date Received �,�5/��� .
<br /> � � '�• Orono, MN;55356
<br /> O O N Main:,952:24 Staff � � �
<br /> ` ', �. 9-4600 � Fee ,$700 �'
<br /> '� ` � ' �* � fax '952�249-4616.'�
<br /> '�" ti - RenewaL ' $35 .
<br /> '��� '. Mailing�Iddress ` ; ,� ` qfter the-fa N
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<br /> t`�ESHOg'� P O,:Box 66: ' �� � � � � : '�1,400 uble�fee .
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<br /> � �+ Crystal�Bay,�MN 55323 0066 ' � ` Escrow�Fee ; ; �, .
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<br /> - . � .. . . • ' .,:r$2;50Q new home/:addition/
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<br /> - < new:structure •
<br /> � � - � t ; ` ,;$ 600 otlie�variance
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<br /> x : This application form must be`completed in�fuil Applicant will be notified within 1'5 days as to the status-of the .=` �
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<br /> application,, Incomple#e a p pl�cations will not be p l a c e d.o n P l a n n i n g C o m m i s s�on'Agen das ; 3 � �;
<br /> � r �� �� '^ f .v s� �F �_ � i t .,� .
<br /> � PROPERTY INF.ORMATION. ' 'a � ` "` ' � ° ;•' . `
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<br /> Site;Address t `.2 9�5 c;9 fco ',�d� 'i�-/-. ,p,o,�p� " ` `3
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<br /> '' Prop'erty•Identifcation`Num'be,r(P.IN)` ,::,ZD -/��=2,3�-3� '0063 V . . a
<br /> � Date�Property A+cquired (montfi/year); 4 � 7 :pP 'p Yes,: I own the ad�acent parceJs
<br /> 'Zonmg District L,�" �c ,r � , y° ~ f, � ' ��� :�
<br /> '���i " i . " 1� 4'1 2 �1 ! - �.y '�
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<br /> "APPLICANT INFORMATION ' (Complete legal names and maritai status required for each interested party)
<br /> �`Name �C.�iFi�a�D'-�4 :l�vE�✓J�'N':�.�%v }Bi�R!�'.iRA � '� n - x " .
<br /> Phone (home) 9 yt o � B` ��F,uJa;�v ` ° :
<br /> S -3 6 =2�5�" t/ S=� �:Phone.(work) f 6'�Z `2 zo -J15a c�
<br /> �,;Complete Address Z g�5 °C',�f�o _�d��vT� ipOaO ' � =j , " .:��
<br /> City,;:State'&ZIP oRe,,.ro ��y ;:553� ,
<br /> =Ernail: � c�'/�{`{�t-d<�su� h sd r� �', c,o r�r ' f �.Fax: �
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<br /> OWNER INFORMATIO.N (Complefie legal,:names and marital<status,required for each interested party)
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<br /> Phone (home) .> , �t -Phone(work): t �
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<br /> �:Complete Acldcess ..� -; . _ ; - `� , : -
<br /> =City,.State & ZIP r � �
<br /> ��Email: � �� 5 u :y � :> . , ` �, � r
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<br /> DESC'RIPTION OF REQUEST: � a " 3 .
<br /> .`,Describe the request in detail`(attach:�additional sheets if necessar�) : _ := � � � ���� � �
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<br /> ,��P FiL.r c���1r� �X/�r��✓'Z' '.D c('/� • �"!'TFPP V�7�iU�T-�r� D��cin� `TO "T�� aC6'
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<br /> �Last Updatetl 5/11/2009 . • � "' .
<br /> , ., ;. ti, . . : °� JAN�:1:5 2010 .
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